MR cholangiography: techniques and clinical applications

Magnetic resonance cholangiography (MRCP) is a new non-invasive imaging technique for the evaluation of bilio-pancreatic disorders. Different sequences, using both breathhold and non-breathhold techniques, have been employed in order to obtain MRCP images. The authors discuss the technical aspects, particularly focusing their attention on a non-breathhold, three-dimensional. fat-suppressed turbo-spin-echo sequence, optimized on a 0.5-T magnet with 15 mT/m gradients. Clinical applications of MRCP are evaluated, presenting data from both the literature and personal experience. The main indication for MRCP study is represented by the evaluation of common bile duct obstruction, with the aim of assessing the presence of the obstruction (accuracy 85-100%) and, subsequently, its level (accuracy 91-100%) and its cause. The utility of associating conventional MR images to MRCP in malignant strictures in order to characterize and stage the malignant lesions is also discussed. Finally, data are presented regarding the indications and utility of MR pancreatography in the evaluation of patients with chronic pancreatitis.